Legislation related to nursing staffing levels has been introduced at the Michigan Capitol.AP file photo

LANSING, MI - The Michigan Nurses Association is again pushing a proposal that would require certain nursing staffing levels at hospitals.

The union-backed proposal would require hospitals to adopt staffing plans with registered professional nurse-to-patient ratios -- such as one nurse per patient in a critical care unit and one nurse for every four patients in a pediatric unit. The proposal also would allow ban mandatory overtime for nurses except in emergency situations.

Supporters say Michigan should become the second state with such a law, following the lead of California, with the goal of improving patient safety. Sponsors of the legislation say mandating a certain number of nurses on duty would reduce patient death rates, infections and other complications while improving the quality of patient care.

The legislation likely faces long odds against approval in the Legislature, where similar bills introduced in recent years have not advanced.

"It’s too early to suggest that any final determination has been made regarding HB 4311, but this proposal has numerous issues that need to be vetted through the committee process before our caucus would be willing to support it," Ari Adler -- a spokesman for House Speaker Jase Bolger, R-Marshall -- said in an email.

Republicans hold majorities over Democrats in both the House and Senate. Democrats are the primary sponsors of both House Bill 4311 and Senate Bill 228.

Rep. Jon Switalski, D-Warren, said Monday the measure is aimed at preventing “chronic understaffing” of nurses. He said the staffing levels can likely be a “life or death issue” in hospitals and that the proposal could affect virtually everyone in the state at some point.

“Michigan residents who need medical care shouldn’t have to worry about whether the hospital will guarantee their safety or gamble with it,” Switalski said.

The Senate bill is sponsored by Rebekah Warren, D-Ann Arbor.

There likely would be cost concerns at hospitals that would have to boost staffing if the measure were to become law. Critics of the bill say it could lead to budget cutbacks in other areas that could jeopardize patient care.

Supporters of the legislation say it could have some cost savings through fewer patient complications, fewer patient re-admissions and reduced overtime costs.

The Michigan Health and Hospital Association opposes the measures, "given that the bills simply seek to achieve staffing ratio mandates and will have no proven effect on patient safety and quality," senior director of advocacy Chris Mitchell said in a statement.

"Michigan hospitals have demonstrated their commitment to patient safety and quality through a decade of voluntary, collaborative, large-scale patient safety and quality improvement initiatives that have saved thousands of lives and hundreds of millions of health care dollars," the statement said.

The statement said that nurse training is the most important factor in assuring high-quality care, as opposed to the number of nurses employed in a given setting.